Cutaneous lymphangitis carcinomatosa made cervicofacial oedema intractable in a patient with superior vena cava syndrome.
Eriko KashiharaOsamu KanaiMisato OkamuraTadashi MioPublished in: BMJ case reports (2018)
Cutaneous lymphangitis carcinomatosa (CLC) is a rare form of cutaneous metastasis that causes lymphoedema and various eruptions. We report a case of lung cancer with CLC that caused both superior vena cava (SVC) stenosis and cervicofacial oedema, suggestive of SVC syndrome. A 64-year-old woman with lung adenocarcinoma presented with cervicofacial oedema and erythema, followed by severe dyspnoea 2 months after four cycles of carboplatin, pemetrexed and bevacizumab triplet therapy. Although chest CT indicated SVC stenosis, cervicofacial oedema remained despite treating the SVC stenosis via balloon dilation. A skin biopsy of the erythematic sample confirmed CLC as the cause of the patient's symptoms. CLC should be considered as a differential diagnosis of cervicofacial oedema in addition to SVC syndrome, especially when it is observed in combination with skin erythema and induration. Moreover, a skin biopsy should be performed promptly for accurate diagnosis of CLC and to decide on appropriate treatment.
Keyphrases
- vena cava
- case report
- inferior vena cava
- soft tissue
- wound healing
- small cell lung cancer
- ultrasound guided
- computed tomography
- high resolution
- magnetic resonance imaging
- randomized controlled trial
- early onset
- squamous cell carcinoma
- bone marrow
- mesenchymal stem cells
- magnetic resonance
- mass spectrometry
- phase ii study
- advanced non small cell lung cancer
- image quality
- study protocol
- rectal cancer
- replacement therapy
- pet ct
- drug induced
- locally advanced
- double blind